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Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma

Background: The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. Material and Methods: In this study, 283 patients with ch...

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Autor principal: Brusini, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509816/
https://www.ncbi.nlm.nih.gov/pubmed/34640431
http://dx.doi.org/10.3390/jcm10194414
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author Brusini, Paolo
author_facet Brusini, Paolo
author_sort Brusini, Paolo
collection PubMed
description Background: The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. Material and Methods: In this study, 283 patients with chronic open-angle glaucoma (OAG) at different stages and 67 healthy subjects were tested with both standard automated perimetry and spectral domain OCT for retinal nerve fiber layer (RNFL) assessment. The visual field data were classified using the Glaucoma Staging System 2, whereas OCT results were processed with the OCT Glaucoma Staging System. These data were used to create a new staging system (global glaucoma staging system, GGSS), in which the severity of visual field and RNFL damage is reported on the Y and X axis, respectively. The GGSS was tested in a different sample of 147 patients with manifest OAG, 56 with preperimetric glaucoma and 43 normal subjects. A six-stage clinical classification, based on the analysis of visual fields and optic disc appearance, was used as gold standard. Results: The GGSS was able to correctly classify in the same stage or within the immediately adjacent stages 145 cases on 147 (98.6%). Fifty-four preperimetric cases (96.4%) were classified as borderline or abnormal (Stage 1 or 2). Here, 41 normal eyes out of 43 were correctly classified as Stage 0, with a specificity of 95.3%. Conclusions: Preliminary results from this study are encouraging and suggest that the new GGSS is able to provide information concerning the severity of structural and functional damage in an integrated manner.
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spelling pubmed-85098162021-10-13 Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma Brusini, Paolo J Clin Med Article Background: The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. Material and Methods: In this study, 283 patients with chronic open-angle glaucoma (OAG) at different stages and 67 healthy subjects were tested with both standard automated perimetry and spectral domain OCT for retinal nerve fiber layer (RNFL) assessment. The visual field data were classified using the Glaucoma Staging System 2, whereas OCT results were processed with the OCT Glaucoma Staging System. These data were used to create a new staging system (global glaucoma staging system, GGSS), in which the severity of visual field and RNFL damage is reported on the Y and X axis, respectively. The GGSS was tested in a different sample of 147 patients with manifest OAG, 56 with preperimetric glaucoma and 43 normal subjects. A six-stage clinical classification, based on the analysis of visual fields and optic disc appearance, was used as gold standard. Results: The GGSS was able to correctly classify in the same stage or within the immediately adjacent stages 145 cases on 147 (98.6%). Fifty-four preperimetric cases (96.4%) were classified as borderline or abnormal (Stage 1 or 2). Here, 41 normal eyes out of 43 were correctly classified as Stage 0, with a specificity of 95.3%. Conclusions: Preliminary results from this study are encouraging and suggest that the new GGSS is able to provide information concerning the severity of structural and functional damage in an integrated manner. MDPI 2021-09-26 /pmc/articles/PMC8509816/ /pubmed/34640431 http://dx.doi.org/10.3390/jcm10194414 Text en © 2021 by the author. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Brusini, Paolo
Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma
title Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma
title_full Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma
title_fullStr Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma
title_full_unstemmed Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma
title_short Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma
title_sort global glaucoma staging system (ggss): a new method to simultaneously assess the severity of both functional and structural damage in glaucoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509816/
https://www.ncbi.nlm.nih.gov/pubmed/34640431
http://dx.doi.org/10.3390/jcm10194414
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